Islet Cell Transplantation in Patients with Unstable Diabetes: A Review of Clinical- and Cost-Effectiveness and Guidelines

Question

What is the clinical effectiveness of islet cell transplantation in patients with unstable diabetes?

What is the cost-effectiveness of using islet cell transplantation in patients with unstable diabetes?

What are the guidelines associated with the use of islet cell transplantation in patients with unstable diabetes?

Key Message

Limited evidence from one health technology assessment suggested that islet transplantation is effective in maintaining insulin independence, and associated with improved clinical outcomes in uncontrolled type 1 diabetic patients: reduced severe hypoglycemia, improved quality of life and reduced progression of diabetic complications were reported in small scale clinical trials with poor quality. The population was not clearly defined in the studies. There is a trend of increasing insulin independence and decreasing adverse events related to this evolving technology in recent years than earlier years. The cost-effectiveness of islet transplantation relative to the current treatment standards is undetermined based on the limited evidence. It has been recommended by evidence-based clinical practice guidelines to be used as an alternative intervention for unstable type 1 diabetes patients.